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5 Most Important Debriefing Questions for Nursing Simulation

When it comes to simulation training, many would argue that it is less effective without the quality debrief that follows. Experts recognize debriefing as an intentional and important phase during the transfer of learning, as well as the cornerstone of experiential learning in high-fidelity simulation.1

Debriefing is an essential methodology that encourages students to "know what", "know how", and "know why." 2

Theory-based, reflective debriefing (when led appropriately) can lead to significant and measurable improvements in a healthcare provider's critical thinking skills.3 On the other hand, when debriefing is conducted poorly, the result is often poor clinical judgment.

Here, we share five of the most important questions to ask when debriefing in nursing education. Using these questions as a guide for your organization, you can ensure that your learners are reaping the full benefit of simulation training.

1. Were you satisfied with your ability to care for the patient(s)?

Think big picture. All learning objectives, whether focused on communication skills, clinical knowledge, preventing harm, or developing team behaviors, are intended to ultimately improve patient care and outcomes. Begin the debrief by gauging how each simulation participant rates their performance in this regard.

As soon as the simulation ends, learners have likely begun to retrace their steps to determine if they were "right" or "wrong". It can be helpful to give them the opportunity to verbally affirm their feelings before the conversation veers in another direction.

2. What was done well and what could have been handled differently?

Next, dive into specifics. Have learners reflect more deeply on exactly why they are satisfied with how the scenario played out. And, set a trusting tone in the debrief environment so that learners can also respectfully voice what didn’t go well.

Participants can learn the most about themselves and others during this portion of the discussion. In responding to this question, learners reflect on their own experience, realize how differently their peers perceived certain moments, and debate the correct clinical pathway. The results that stem from this question can be improved self-awareness, better team collaboration, and a stronger understanding of the curriculum material.

3. What did you learn?

Though this next question may not lead to an extensive group discussion, it can help to make learning stick. When addressing this question, learners are tasked with quickly narrowing down what their most important takeaway has been. And, in saying the lesson they learned aloud, they are more likely to remember it.

Because the answers are individualized, they may be similar or they may vary greatly. Perhaps one learner experiences an "Aha!" moment and can finally grasp a specific diagnosis and treatment plan. Or, maybe another learner develops the confidence to point out a patient safety risk factor. Whatever a learner’s takeaway is, be sure to coach them to refine it as much as possible. 

4. How could this simulation experience be improved?

The post-simulation debrief gives educators the chance to candidly ask what learners think of the teaching method. Was the simulation realistic enough? Were participants adequately prepared prior to entering the simulation scenario? Were there moments that the suspension of disbelief was abruptly lifted?

There's always room to improve and refresh a simulation scenario. Any feedback learners can provide will only strengthen the experience for the next group of participants, so make sure to keep an open mind when asking this question.

5. Is there anything else you would like to discuss?

While it's critical to have pre-prepared questions in a post-simulation debrief, it's equally important to give participant’s the chance to broach other conversations (within reason). Most likely, an observation made by one individual is something that others noticed as well, and that makes it a worthy topic of discussion.

Being too rigid in the debrief format can run the risk of making it less effective. Instead, keep the flow of conversation natural and informal, and you’ll be surprised by the number of unexpected and valuable nuggets of information that you hear.

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